【摘要】 目的探讨慢性粒细胞白血病(CML)患者骨髓细胞中 Wilms 瘤抑癌基因(WT1)的表达水平及其临床意义。方法建立实时定量 RT-PCR 方法,采用 Light Cycler PCR 仪检测了46例(109份骨髓细胞 cDNA 标本)CML 患者和23例非白血病患者骨髓细胞中 WT1及内参β胆色原脱氢酶(GAPDH)的表达水平,以 WT1_N=(WT1拷贝数/GAPDH 拷贝数)×10~4计算 WT1表达水平。结果23份 CML 加速期与22份 CML 急变期患者骨髓细胞中 WT1_N 的中位表达水平分别为103.71和129.44,明显高于64份 CML 慢性期和对照组(分别为3.44和1.47,P<0.01),对照组与 CML 慢性期之间 WT1基因表达差异无统计学意义;CML 加速期与急变期之间 WT1基因表达差异也无统计学意义(P<0.05)。WT1基因表达水平与 BCR/ABL 融合基因表达水平具有一定的相关性。对其中7例 CML 患者行异基因骨髓移植前后动态检测 WT1上升可提示白血病复发。结论 CML 患者加速急变期骨髓细胞中 WT1基因表达升高,具有参考意义。更多还原

【Abstract】 Objective To investigate the clinical significance of Wilms tumor gene(WT1) expression levels in the bone marrow(BM)of chronic myelogenous leukemia patients.Methods Real-time quantitative retroverse polymerase chain reaction(RQ-RT-PCR)method was established for detecting WT1 and GAPDH expression levels in the BM of 109 CML and 23 non-leukemic patients with Light Cycler. Normalized WT1 expression level(WT1_N)was determined as a ratio between WT1 and GAPDH expression times 10~4.Results The median expression levels of WT1_N in 23 CML patients of accelerate phase(CML- AP)and 22 CML patients of blast crisis(CML-BC)were statistically higher than those of 64 CML patients of chronic phase(CML-CP)and 23 non-leukemic controls(103.71 and 129.44 vs 3.44 and 1.47).No statistic differences were found between the CML-CP group and control group,nor between the CML-AP group and CML-BC group.Furthermore,the WT1_N levels were correlated to the BCR/ABL fusion gene expression levels.Dynamic change of WT1_N levels in 7 CML patients before or after allo-geneic bone marrow transplantation showed that WT1 expression levels could predict relapse of leukemia.Conclusion WT1 expression levels in CML patients in accelerate phase or blast crisis were strikingly higher than those in non- leukemic patiens or CML patients in chronic phase,in whom WT1 expression was undectable or showed low expression.WT1 gene could be an useful marker for detecting MRD and evaluating therapeutic efficacy in CML.更多还原